The Ministry of Health (MINSA) bought some 16 million Ivermectin and Colchicine tablets from Laboratorios Ramos, owned by the Nicaraguan Institute of Social Security (INSS), two drugs not recommended by international organizations to treat Covid-19. The acquisitions, dated between March and September, 2021, had a total cost of US $735,959 -equivalent to about 25.9 million cordobas, at the official exchange rate-, reveals a series of “Covid-19 contracts,” recently published in the Electronic Administrative Contracting System (SISCAE).
According to the contracts, the total purchase of Ivermectin was 7 million tablets, one million was purchased on March 16 and the rest on August 20th. The investment was $81,196 dollars. The purchase of Colchicine amounted to 9 million tablets, purchased on the same date in August, for an amount of $654,763.
“We recommend not using Ivermectin in patients with Covid-19, except in the context of a clinical trial. This recommendation applies to patients with any severity of the disease and any duration of symptoms,” stated the World Health Organization (WHO) in the treatment guidelines against Covid-19, updated as of March 31, 2021.
MINSA made the decision to distribute Ivermectin tablets from house to house among the healthy and sick population as a way to prevent the outbreak of Covid-19. The pandemic has exponentially spread in both infections and deaths since the end of last August. The decision was made even though its use is not approved by either the WHO or the Food and Drugs Administration (FDA).
“Until today there is no specific, preventive treatment or cure for this disease. The treatment is based on the handling of the ailments. Ivermectin and Colchicine do not work. No informed doctor should be providing Colchicine and Ivermectin, because they do not work,” says epidemiologist Leonel Arguello.
Likewise, in the acquisitions made by MINSA, between March and September, the purchase of Simvastatin and Vitamin D, other drugs that have been used in patients with Covid-19 are itemized, but which still do not have conclusive results on their benefits. These drugs were purchased from Distribuidora Cruz Azul, which is also related to INSS, and from Drogueria Nunez. The total amount of this purchase was for the equivalent of US $27,092.
An infectious disease doctor, who requested anonymity, explained that statins, the group to which Simvastatin belongs, have improved the prognosis of coronavirus patients who took it in advance due to cholesterol problems. However, “it has not shown benefits” with other covid patients, so “more research and studies are needed.”
Altogether, between March and September, 27 “Covid contracts” were published, at two different times: four between April and May, and the other 23 in September. In the former, a minor purchase of Ivermectin, Simvastatin and Vitamin D had already been revealed.
23 New “Covid Contracts”
According to the update of “Covid contracts,” which were published by the Ministry of Finance and Public Credit (MHCP), between March and September, MINSA awarded 23 purchases amounting to US $15,668,697.00.
The Government published these contracts as part of a transparency agreement that the Government of Daniel Ortega established with multilateral organizations to access loans and funds to respond to the pandemic.
In total, Laboratorios Ramos won three of the 23 contracts allocated for a total amount of 1,062,328.00 dollars, with which it bought other drugs to treat Covid-19, in addition to Colchicine and Ivermectin.
Fifty percent of the “Covid contracts” were destined for the purchase of replacement supplies and reagents from the National Center for Diagnosis and Reference (CNDR). According to their description, the Cam International Company, which provides equipment, reagents and laboratory supplies, was the one that won the most expensive contracts. In total, three were awarded for an amount of 4.2 million dollars. With these MINSA acquired medical supplies to carry out PCR tests, such as reagent kits for RNA extraction, reaction plates, filters, among others.
The Yale Healthcare Company won two “Covid contracts” amounting to 3.6 million USD. With these MINSA bought medicines such as: Clindamycin, which is used to treat lung infections: Voriconazole, for fungal infections; Colistin, an antibiotic against bacteria. They also purchased gloves, catheters, bandages, gauze, oximeters, surgical caps, shoe covers, syringes, among other supplies.
The Medical and Laboratory Supplies Dealer (Dismelab SA) got two contracts that amounted to 2.5 million dollars and will be used to buy reagents for tests and medical supplies. Among them: nitrile gloves, ethanol, polystyrene tubes, bio-safety bags, and plate fixers.
US $1,211 for each vile
MINSA also invested in the purchase of Tocilizumab, a medicine that has been shown to “reduce mortality and the need for invasive ventilation, without a significant increase in serious adverse effects in patients with severe or critical illness from Covid-19, according to the WHO guide for treatments.
This medicine, which is produced exclusively by Roche pharmaceutical company, is expensive. For each vial of Tocilizumab (400 mg/20ml), MINSA paid about $1,211 USD. it acquired 1,671 viles in total, for which the Medical Nicaragua SA company won the single contract for $2,024,524.
Likewise, the Ministry of Health bought 2,100 vials of Tocilizumab (162 mg/0.9ml) for a total sum of $344,231 USD. These were bought partly from Distribuidora Cruz Azul and DICEGSA.
The Generic Pharma GP SA company won two contracts totaling 1.1 million dollars, with these they acquired injections of meropenem, voriconazole that is used in Covid patients who develop pulmonary aspergillosis, in addition to hydrocortisone, diazepam, dopamine, among other medicines.
Masks for the MINED
Among the “Covid contracts” there were ten that consisted of minor purchases, ranging from 5,523 USD, which the Ministry of Education (MINED) allocated to masks, to $276,000 which they used to buy insulin, a drug for diabetes.
These minor contracts were won by Imfarsa, Neo Ethicals, Distribuidora Cruz Azul, Drogueria Nunez, NPro Medical Corporation and DICEGSA. Several of these companies had already benefited from “Covid contracts,” as documented by various Confidencial reports.
The first time that the Government of Daniel Ortega published information related to state purchases in response to Covid-19 was in November 2020. On that occasion it was about the publication of 19 state purchase contracts, which amounted to ten million dollars.
Afterwards it added five “Covid contracts” allocated to MINED for an amount of US $471,014 that were used to buy mops, brooms and soaps for washing dishes. In April 2021, they published six more contracts that were allocated for the purchase of personal protection, such as masks, gel alcohol and thermometers for the border posts of Penas Blancas, San Pancho and Guasaule, for an amount of US $13,555.
Despite the commitment to transparency acquired, the Government of Ortega does not publish the complete list of contracts for Covid-19, since they have only included in the section “Covid-19 contracts” of the Electronic Administrative Contracting System (SISCAE), 53 of the completed tenders, which exclude contracts that benefitted companies allied to the regime. As it was demonstrated by the investigation “The lucrative recipe for Covid in Nicaragua,” prepared by the regional journalistic platform, Connectas.
Despite the fact that the Ministry of Health made several purchases to attend the pandemic, between March and September 2021, the investment is very little. According to a Confidencial analysis, during the first semester of this year the Government received the equivalent of 118.1 million USD destined exclusively for the fight against Covid-19, but as of June 30, only a total of 13.5 million have been executed.
This article was originally published in Spanish in Confidencial and translated by our staff